Report 2015-131 Recommendation 2 Responses

Report 2015-131: California's Foster Care System: The State and Counties Have Failed to Adequately Oversee the Prescription of Psychotropic Medications to Children in Foster Care (Release Date: August 2016)

Recommendation #2 To: Los Angeles County

To better ensure that foster children only receive psychotropic medications that are appropriate and medically necessary, counties should ensure that all foster children are scheduled to receive a follow-up appointment within 30 days of starting a new psychotropic medication.

Agency Response*

The Juvenile Court now orders a 45-day progress report for every new medication or increased dosage on a previously approved medication. Among other things, that report requires information on whether or not the child was seen by the prescribing physician within the 30-day timeframe recommended by the State Auditor.

(Please see supporting documentation. The revised approval and monitoring protocols were submitted as attachments to our February 23, 2017, response. Attached to this response are newly revised policies and procedures from the Department of Children and Family Services regarding psychotropic medication, and newly revised policies and procedures from the Department of Public Health on the role of public health nurses in the new approval and monitoring protocols.)

  • Response Type†: 1-Year
  • Completion Date: April 2017
  • Response Date: August 2017

California State Auditor's Assessment of Status: Resolved

The documents that Los Angeles County mentions are available from our office.


Agency Response*

Los Angeles County protocols now require 30-day follow-ups to be documented in progress reports ordered by Juvenile Court judges 45 days after they approve any new medication or an increase in dosage of a previously authorized medication.

Our next progress report for the State Auditor will include our efforts at the complete implementation of the new procedures outlined in our response to Recommendations 1 and 2.

(Please see supporting documentation.)

  • Response Type†: 6-Month
  • Estimated Completion Date: 04/15/2017
  • Response Date: February 2017

California State Auditor's Assessment of Status: Pending


Agency Response*

Over the next year, the Workgroup detailed in our response to Recommendation 1 will develop strategies to ensure that all foster children are scheduled to receive a follow-up appointment within 30 days of starting a new psychotropic medication.

The Workgroup's agenda will also focus specifically on issues raised in the report of the State Auditor to the extent that the implementation of its recommendations is not being met by our ongoing work. For instance, in 2009, Los Angeles County implemented monitoring protocols for both the dependency court and the delinquency court. Those protocols require the court to set a progress report 40 days after it approves any new medication or an increase in dosage of a previously authorized medication. Among other things, that report is required to include the date of the follow-up visit with the prescribing physician. We will need to revisit this issue to ensure that the follow-up visits occur within the timelines stated in the State Auditor report.

(Please see supporting documentation.)

  • Response Type†: 60-Day
  • Estimated Completion Date: 08-23-2017
  • Response Date: October 2016

California State Auditor's Assessment of Status: Pending


All Recommendations in 2015-131

†Response Type refers to the interval in which the auditee is providing the State Auditor with their status in implementing recommendations made in an audit report. Auditees must submit a response regarding their progress in implementing recommendations from our reports at three intervals from the release of the report: 60 days, six months, and one year or subsequent to one year.

*Agency responses received after June 2013 are posted verbatim.


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